Kim S J, Kim H K
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Clin Orthop Relat Res. 1995 Aug(317):237-42.
In 147 patients with arthroscopically proved chronic injuries of the anterior cruciate ligament, the anterior drawer test, the Lachman test, and the pivot shift test were done before operation under general or spinal anesthesia. Results of the anterior drawer test were positive in 79.6% of the patients, in 98.6% patients having the Lachman test, and in 89.8% of patients having the pivot shift test. In 19 cases (12.9%), arthroscopic examination showed reattachment of the proximally torn end of the anterior cruciate ligament to the posterior cruciate ligament. In these cases, results of the anterior drawer test were positive in 13 patients (68.4%), in 17 (89.5%) patients having the Lachman test, and in 12 patients (63.2%) having the pivot shift test. In 15 cases with a false negative pivot shift test, arthroscopy showed blockage of anterior subluxation of the lateral tibial condyle by a partially functioning portion of the anterior cruciate ligament, which was reattached to the posterior cruciate ligament in 7 cases. In 2 cases with a false negative Lachman test, there was firm reattachment of the torn end of the anterior cruciate ligament to the proximal portion of the posterior cruciate ligament combined with a bucket handle tear of the medial meniscus. The Lachman test was most sensitive in diagnosing chronic injuries of the anterior cruciate ligament. The pivot shift test was also sensitive but was influenced by many factors.
在147例经关节镜证实为前交叉韧带慢性损伤的患者中，于全身麻醉或脊髓麻醉下在术前进行了前抽屉试验、拉赫曼试验和轴移试验。前抽屉试验结果在79.6%的患者中为阳性，拉赫曼试验在98.6%的患者中为阳性，轴移试验在89.8%的患者中为阳性。19例（12.9%）患者的关节镜检查显示前交叉韧带近端撕裂端重新附着于后交叉韧带。在这些病例中，前抽屉试验结果在13例患者（68.4%）中为阳性，拉赫曼试验在17例（89.5%）患者中为阳性，轴移试验在12例患者（63.2%）中为阳性。在15例轴移试验假阴性的病例中，关节镜检查显示外侧胫骨髁前半脱位被部分发挥功能的前交叉韧带部分阻挡，其中7例该韧带重新附着于后交叉韧带。在2例拉赫曼试验假阴性的病例中，前交叉韧带撕裂端牢固地重新附着于后交叉韧带近端部分，并伴有内侧半月板桶柄状撕裂。拉赫曼试验在诊断前交叉韧带慢性损伤方面最为敏感。轴移试验也很敏感，但受多种因素影响。
